POS0862 PRESCRIPTION PATTERN OF JAK INHIBITORS OVER 5 YEARS IN ITALY: DATA FROM THE ITALIAN NATIONAL GISEA REGISTRY
Authors: F. R. Spinelli, F. Iannone, E. G. Favalli, E. Gremese, S. Bugatti, C. Garufi, F. Atzeni, A. Cauli, M. Sebastiani, A. Carletto, M. Govoni, A. Semeraro, R. Foti, F. P. Cantatore, C. Bazzani, S. Parisi, M. S. Chimenti, B. Frediani, R. Caporali, F. Conti
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Since 2018, JAK inhibitors became available in Italy for the treatment of adult patients with moderately to severely active Rheumatoid Arthritis (RA) and an inadequate response to methotrexate (MTX). <h3>Objectives</h3> This analysis aimed to characterize the prescription pattern of JAK inhibitors in patients with RA over the last 5 years. <h3>Methods</h3> Patient demographics, disease characteristics and medication history were collected. Patients starting treatment either with biological Disease Modifying Anti-Rheumatic Drugs (bDMARDs) or targeted synthetic (ts)DMARDs (baricitinib, tofacitinib, upadacitinib and filgotinib) were included in the analysis. Data were extracted from the GISEA (Gruppo Italiano di Studio sull'Early Arthritis) registry. <h3>Results</h3> From January 2018 to December2022 overall 4424 patients with RA were included in the GISEA registry (3622 F: 802 M, mean age 57.9±12.8 years, mean disease duration 12.9±9.9 years). Overall, the number of patients starting bDMARDs and tsDMARDs in 2018, 2019, 2020, 2021 and 2022 was 729, 784, 1204, 794 and 913, respectively; 306 (42%), 319 (40,7%), 278 (23%), 291 (36.6%) and 335 (36.7%) started a JAK inhibitor. Figure 1 summarizes the prescription pattern of bDMARDs and tsDMARDs during the 5 years of observation (A) and the percentage of patients starting each JAK inhibitor (B). The prescription of JAK inhibitors was stable from 2018 to 2022 with the only exception of 2020 (coinciding with the beginning of the pandemic) when we recorded a significant decrease in JAK inhibitors prescribed (p&lt;0.00001 vs 2019) and a significant increase in the number of patients treated with abatacept (from 12.1% to 17.1%, p=0.0024) and anti-IL-6R (from 16.3% to 23.7%, p=0.000067). Conversely, in 2021 the number of patients who started JAK inhibitors significantly increased (0&lt;0.00001 vs 2020) and those starting anti-IL-6R significantly decreased (from 23.7% to 13.4%). From 2018 to 2022 the percentage of bDMARD-naive patients increased, without reaching a statistical significance, from 30.7%, 36%, 43.5%, 44.4%, 40.3% of patients starting a JAK inhibitor after MTX-failure (Figure 1C). <h3>Conclusion</h3> The use of JAK inhibitors for treating RA of patients in Italy is stable from 2018 onward with a shift towards an earlier line of treatment and a significant change in the prescription pattern within the class over time. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Francesca Romana Spinelli Speakers bureau: Amgen, Abbvie, Eli Lilly, Galapagos, Consultant of: Abbvie, Eli Lilly, Galapagos, Florenzo Iannone Speakers bureau: Abbvie, Galapagos, Eli Lilly, Merck Sharp &amp; Dohme, Pfizer, Roche, UCB, Consultant of: Abbvie, Galapagos, Eli Lilly, Merck Sharp &amp; Dohme, Pfizer, Roche, UCB, Ennio Giulio Favalli Speakers bureau: BMS, Lilly, Roche, MSD, UCB, Pfizer, Sanofi-Genzyme, and Abbvie, Consultant of: BMS, Lilly, Roche, MSD, UCB, Pfizer, Sanofi-Genzyme, and Abbvie, Elisa Gremese Speakers bureau: Abbvie, BMS, Eli Lilly, Galapagos, Consultant of: Abbvie, BMS, Eli Lilly, Galapagos, Serena Bugatti Speakers bureau: bbVie, Bristol-Myers Squibb, Eli Lilly, Galapagos, Pfizer and Sanofi, Consultant of: Abbvie, Grant/research support from: Pfizer, cristina garufi Speakers bureau: Eli Lilly, Fabiola Atzeni: None declared, Alberto Cauli: None declared, Marco Sebastiani Speakers bureau: Eli Lilly, BMS, Pfizer, Antonio Carletto: None declared, Marcello Govoni: None declared, Angelo Semeraro: None declared, Rosario Foti: None declared, Francesco Paolo Cantatore: None declared, Chiara Bazzani Consultant of: Abbvie, Simone Parisi: None declared, Maria Sole Chimenti Speakers bureau: Abbvie, Eli Lilly, Galapagos, Bruno Frediani Speakers bureau: Abbvie, ELi Lilly, Galapagos, Roberto Caporali Speakers bureau: Abbvie, BMS, Eli Lilly, Galapagos, Pfizer, Roche, UCB, Consultant of: AbbVie, Accord, BMS, Celltrion, Ely Lilly, Fresenius-Kabi, Galapagos, Pfizer, Roche, Sandoz, Fabrizio Conti Speakers bureau: Abbvie, BMS, Eli Lilly, Galapagos, UCB.